Gene/Protein Disease Symptom Drug Enzyme Compound
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This article describes the approach of the KIWAKKUKI women's group in helping to change sex behavior among youth and to inform community women's groups in Moshi, Tanzania. The group concluded after four years of experience that people change risky sexual behavior most when participatory methods based on local culture are used in educational programs. KIWAKKUKI established discussion groups for primary and secondary school students in the schools. The approach included use of videos, clothboards, chalkboards, and sometimes role plays. The mothers engaged in discussions with children other than their own, which reduced some embarrassment. Sex education discussion groups were also conducted among church youth and community women's groups. Monthly meetings drew a membership of about 356 persons, of whom 30-50 were trainers and advocates. Some of the topics of conversation were knowledge about physical bodies and personalities, assertiveness and the ability to say "no," laws and regulations relating to marriage, inheritance, sexual harassment, abuse, and AIDS. Other topics focused on the cultural understanding of circumcision, teeth extraction, wife inheritance, and women's income generation. The basic premise of their operation is empowerment of women and the belief that women can make a difference in changing culture. Men, who indicated an interest in forming a group, were redirected to their own group formation.
AIDS STD Health Promot Exch 1995
PMID:Country watch: Tanzania. 1234 73

This study was conducted to determine the significance of an isolated positive (where all other syphilis serology is negative) syphilis enzyme immunoassay (EIA) test (ICE syphilis: Murex Diagnostics) in a sexual health clinic population. There were significantly greater numbers of isolated positive syphilis EIA tests at Sydney Sexual Health Centre (SSHC) (22/5478) compared to lower risk populations; Southeastern Sydney antenatal clinics (1/11,560, P<0.01) and Sydney Children's Hospital (0/3550, P<0.01). We conducted a case control study comparing the cases at SSHC with two control groups drawn from the clinic population. A manual review of the case medical records searched for a history of suggested syphilis. Within the 22 cases, 32% had clinical grounds for suspecting that the EIA test signified syphilis. Men reporting homosexual contact in the past 12 months significantly distinguished cases from controls who tested negative for syphilis (OR=6.06). An isolated positive EIA test should prompt further investigation for syphilis, past or present.
Int J STD AIDS 2002 Nov
PMID:Investigation of isolated positive syphilis enzyme immunoassay (ICE Murex) results. 1243 96

The demographic, risk-taking, psychological, and social network characteristics of HIV+ patients receiving and not receiving antiretroviral therapy were compared to those characteristics in HIV+ and HIV- persons who are not in care. In this cohort study, we enrolled patients from the Grady Infectious Disease Program (IDP) Clinic in Atlanta, GA, defining group membership by their use of antiretroviral therapy at the time of ascertainment. We also enrolled HIV+ and HIV- persons from inner city neighbourhoods of Atlanta. We collected extensive survey information from both groups, as well as clinic and follow-up information from the Clinic groups. We attempted to interview each participant four times over a period of two years. We used scores for Risk, for Social Stress and for Psychological Distress to compare the groups. Persons receiving antiretroviral therapy continued to display risky behaviour and to experience a substantial degree of social stress and psychological distress. HIV+ persons in the community, however, had the most prominent profile for HIV-transmission risk, social stress, and psychological distress and display considerable cross-over in their patterns of risk-taking. Men who have sex with men appear to play a dominant role, through their risk behaviour and network affiliations, in the maintenance of HIV endemicity. Current approaches fail to give sufficient attention to the admixture of risk that occurs in inner city communities. Reaching HIV+ persons with antiretroviral therapy in such communities faces considerable social, structural, and psychological barriers that may be more important than simple adherence to medication.
Int J STD AIDS 2003 Jul
PMID:Once and future HIV treatment: a comparison of clinic and community groups. 1286 22

The study objective was to estimate the prevalence of selected sexually transmitted infections (STIs) and associated factors among Dhaka slum dwellers. Blood and urine specimens were collected from 1534 men and women. Participants in this cross-sectional study responded to a questionnaire, providing socioeconomic data, symptomatology and treatment-seeking behaviour. Specimens were tested for syphilis, hepatitis B (HBsAg), Neisseria gonorrhoeae, Chlamydia trachomatis, and HIV. Serologic evidence of syphilis infection was found in 6.0% of respondents, HBsAg in 3.8%. Prevalence rates of gonorrhoea and chlamydia were 1.7% and <1%, respectively. No HIV infections were found. Men were more than twice as likely as women to be infected with syphilis or HBsAg carriers. Behaviours facilitating STI transmission were common among men. Syphilis infection is prevalent enough to warrant the initiation of screening programmes in this population. The prevalence rate of hepatitis B carriage suggests that this population would benefit from universal vaccination against hepatitis B.
Int J STD AIDS 2003 Sep
PMID:Sexually transmitted infections prevalence rates in slum communities of Dhaka, Bangladesh. 1451 98

Our objective was to compare the sensitivities for the detection of Chlamydia trachomatis, of the ligase chain reaction (LCR) on first voided urine (FVU) specimens and enzyme immunoassay (EIA) on pooled endocervical/endourethral swabs from women and endourethral swabs from men. Men and women taking part in the UK chlamydia screening pilot were tested for chlamydia using LCR on a FVU. Patients attending genitourinary medicine clinics also had cervical and/or urethral swabs taken for chlamydia testing by EIA. In women, EIA on pooled swabs detected 575 of the 785 chlamydia positives and in men, EIA detected 209 of 351 positives. The sensitivity of EIA was 73% and 60% in women and men respectively. By using the EIA test, therefore, 27-40% of patients infected with chlamydia will be given a false negative result. We propose that it is unethical to use non-molecular testing in the future.
Int J STD AIDS 2003 Nov
PMID:Screening for genital chlamydia infection: DNA amplification techniques should be the test of choice. 1462 32

The current study examined social network and drug use factors associated with buying and selling sex among a sample of opiate and cocaine users in Baltimore, Maryland. A sample of 702 drug users who were sexually active were administered a social network and risk behaviour inventory. Compared to 25% of men, only 1.7% of women reported a history of giving money or drugs to get sex during the past 90 days. Conversely, more women (21.2%) than men (4.7%) sold sex for money or drugs. Those who sold sex were more likely to be low frequency crack smokers, were more likely to drink alcohol at least once a day, had a higher average number of crack-only smokers in their network, and had a smaller number of kin in their network. Men who exchanged money or drugs for sex tended to be low frequency crack smokers and reported having more crack-only smokers and injectors and fewer kin in their networks. The results suggest that network composition may be a risk factor for exchanging sex, particularly with respect to crack users, while kin may be a protective factor. These associations may be either a cause or consequence of exchanging sex.
Int J STD AIDS 2003 Nov
PMID:The relationship between social network characteristics and exchanging sex for drugs or money among drug users in Baltimore, MD, USA. 1462 42

Seventy-eight men with a history of chronic urethritis were referred for investigation. Of 52 men diagnosed as having persistent or recurrent non-gonococcal urethritis (NGU) at the time of referral, 11 (21%) were infected with Mycoplasma genitalium and three with Chlamydia trachomatis. Men who were M. genitalium-positive had not previously received less antibiotic, in terms of treatment duration, than those who were M. genitalium-negative, suggesting a possible resistance to the antibiotics given. In the current investigation, of 11 M. genitalium-positive men with persistent or recurrent NGU who were treated for four to six weeks with erythromycin, 500 mg four times daily, nine (82%) responded clinically and microbiologically, but later six relapsed without M. genitalium being detected. The results of observing and investigating a patient for about one year, the only one to have concurrent chlamydial and mycoplasmal infections, is presented, a feature being the intermittent persistence of the mycoplasma.
Int J STD AIDS 2004 Jan
PMID:Mycoplasma genitalium in chronic non-gonococcal urethritis. 1476 66

We assessed HIV antibody and risk exposures in a cross-sectional sample of 446 fishermen in Sihanouk Ville, a port and fishing area in Cambodia, where high HIV prevalence has been found in sentinel surveillance studies. HIV prevalence was 16.1%, and was highest among unmarried men (17.3%) compared with married (14.6%). Men who stayed in port over one day had a significantly higher prevalence of HIV (31.7%) than those in port for <or = day (14.6%). Men who had sex exclusively with their wife or girlfriend in the previous three months were significantly less likely to be HIV-infected than those who reported no sexual relations during the same time period (11% vs 23.7%, respectively). HIV infection in Cambodian fishermen was more than double that estimated in the general Khmer population. Although a large-scale condom promotion programme has been implemented in Sihanouk Ville, additional prevention programmes are needed to prevent further spread of HIV.
Int J STD AIDS 2004 Jul
PMID:HIV prevalence and risk factors among fishermen in Sihanouk Ville, Cambodia. 1522 34

Our objective was to determine a sociodemographic profile (typology) of men for whom a relatively greater number of sex partners was associated with engaging in unprotected anal sex. A cross-sectional survey of 150 men who have sex with men (MSM) attending a large sex resort was conducted. The sex resort was located in the Southeastern United States. Men from 14 states attended the resort and completed an anonymous, self-administered, questionnaire. The typology that emerged showed that the co-occurring risk behaviours (greater number of partners and having unprotected sex) were reported by older men (P = 0.002), men with incomes of at least US 50,000 dollars (P = 0.018), men growing up in rural areas (P = 0.005), men who were not knowingly HIV positive (P = 0.004), and men who had received the full series of vaccinations against hepatitis B (P = 0.029). This typology may be useful for more efficient targeting of prevention and counselling programmes designed to reduce sexually transmitted infection incidence among this high-risk (and understudied) population of MSM.
Int J STD AIDS 2005 Feb
PMID:Gay men who attend sex resorts: a typology associated with high-risk sexual behaviour. 1580 45

Few analytic opportunities have allowed us to evaluate the role that specific sexual acts and male latex condoms play in the acquisition of external anal warts (EAW) using longitudinal data. The acquisition of EAWs occurs from epithelial contact with other HPV-infected surfaces, and hence is dependent upon sexual behaviour. Our objectives were to classify the relative importance of condom use, receptive anal intercourse (RAI) and prior history of EGWs on acquisition of EAWs. The observational Multicenter AIDS Cohort Study followed 2925 men over nine semiannual study visits for behavioural and physical examinations with laboratory testing. The main outcome measure was the occurrence of examiner-diagnosed EAWs in a homosexual population. EAWs were diagnosed among 10% of men studied across 22,157 visits reviewed for this study. Men with history of EGWs were more likely than those previously unaffected to have developed EAWs (cOR = 2.4 (2.0, 2.9)), as were men who reported multiple anoreceptive intercourse partners (e.g., compared with men who reported no RAI partners, men with 1, 2-5, > or = 6 RAI partners had crude risk ratios 1.0 (0.8, 1.3), 1.6 (1.2, 2.1), 3.9 (2.7, 5.8), respectively). These relations persisted after other demographic and sexual risk factors were controlled for in the analyses. Consistent condom usage showed no protective effect for EAWs in our crude or adjusted analyses. Patient education messages should be tailored to reflect our uncertainty about the protective nature of condoms for the development of anal warts, but to continue to assert the protective effects of a limited lifetime number of sexual partners and the heightened risk for wart recurrence once infected.
Int J STD AIDS 2005 Mar
PMID:How condom use, number of receptive anal intercourse partners and history of external genital warts predict risk for external anal warts. 1582 20


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